Acoramidis Transthyretin Amyloidosis Prevention Trial in the Young (ACT-EARLY) Study in Asymptomatic Carriers of a Pathogenic TTR Variant

Last updated: May 15, 2025
Sponsor: Eidos Therapeutics, a BridgeBio company
Overall Status: Active - Recruiting

Phase

3

Condition

Amyloidosis

Circulation Disorders

Treatment

Acoramidis

Placebo oral tablet

Clinical Study ID

NCT06563895
AG10-501
  • Ages 18-75
  • All Genders

Study Summary

Transthyretin amyloidosis (ATTR) is a disease where the normally occurring transthyretin (TTR) protein falls apart and forms amyloid, a sticky plaque- like substance that accumulates in different organs in the body and can cause damage to the organ. There are two ways that the TTR protein can fall apart. One way occurs as a person ages, where the normal TTR protein can fall apart and form amyloid that may no longer be sufficiently cleared by the body. This type of ATTR is known as wild-type ATTR (ATTRwt). The other way occurs when a person inherits a defective TTR gene that causes the TTR protein to spontaneously fall apart. This form of the disease is known as variant ATTR (ATTRv) and can be detected in adults by a genetic test of their TTR gene before they age.

Amyloid build-up in the heart causes the heart wall to become thick and stiff and can result in heart failure and even death. Accumulation of TTR amyloid in the heart is known as transthyretin amyloid cardiomyopathy or ATTR-CM. Amyloid can also deposit in the nerve tissues leading to nerve problems. Accumulation of TTR in the nerves is known as transthyretin amyloid polyneuropathy or ATTR-PN.

Acoramidis is an experimental drug designed to bind tightly to TTR in the blood and stabilize its structure, so it does not form the harmful amyloid plaques that can cause damage to organs.

This study is intended to determine if treatment with acoramidis in participants with ATTRv who have not yet developed any symptoms of disease can prevent or delay the development of ATTR-CM or ATTR-PN disease. If adults with an inherited defective TTR gene are treated early before any of the symptoms of disease have developed, it may be possible to delay the onset or prevent the disease entirely.

Eligibility Criteria

Inclusion

Key Inclusion Criteria:

  • Male or female ≥ 18 to ≤ 75 years of age inclusive.

  • Participants must have an established genotype (hetero- or homozygosity) of a TTRgene variant that is known to be pathogenic (eg, V30M/p.V50M, V122I/p.V142I,T60A/p.T80A, or any other pathogenic TTR variant(s)) confirmed by central laboratoryprior to randomization.

  • Participant's age is no more than 10 years (≤ 10) younger than the PADO.

Exclusion

Key Exclusion Criteria:

  • Evidence of ATTR-CM or ATTR-PN.

  • Presence of a TTR variant known to be phenotypically protective (eg, T119M, R104H).

  • Current or past treatment with other TTR modifying therapies.

  • Contraindication to or inability to undergo Cardiac magnetic resonance testing.

  • Major organ dysfunction, including: kidney disease, liver disease, heart disease (including cardiomyopathy), neuropathy

  • Other diseases or conditions such has cancer within 3 years, untreatedhyperthyroidism or hypothyroidism, type 1 diabetes, active hepatitis B or C, HIV.

  • Major surgery within the past 3 months or planned during the next 12 months.

  • Known hypersensitivity to acoramidis.

Study Design

Total Participants: 582
Treatment Group(s): 2
Primary Treatment: Acoramidis
Phase: 3
Study Start date:
May 12, 2025
Estimated Completion Date:
December 31, 2032

Study Description

The AG10-501 ACT-EARLY study is a randomized, multicenter, double-blind, placebo- controlled study of acoramidis for prevention of ATTR (with specific reference to either its cardiomyopathic or polyneuropathic manifestations). Participants will be stratified at randomization.

The study population will be asymptomatic carriers of a known pathogenic TTR gene variant. A participant must be 18 to 75 inclusive years of age, and the age of the participant must be no more than 10 years younger than the predicted age of disease onset (PADO) based either on family history (pedigree analysis) or, if family history is insufficient, based on a TTR Variant Actuarial table from published literature. For example, if PADO for a given individual is found to be 50 years, the age of the participant must be between 40 and 75 years inclusive.

Connect with a study center

  • UMHAT Aleksandrovska Sofia, Clinic of Neurology Diseases

    Sofia,
    Bulgaria

    Active - Recruiting

  • Azienda Ospedaliero-Universitaria Careggi

    Florence,
    Italy

    Active - Recruiting

  • Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica - Ospedale San Cataldo

    Pisa, 56124
    Italy

    Active - Recruiting

  • Fondazione Policlinico Universitario A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore

    Rome, 00168
    Italy

    Active - Recruiting

  • Universitair Medisch Centrum Utrecht

    Utrecht, 3584 CX
    Netherlands

    Active - Recruiting

  • Hospital Universitario Juan Ramon Jimenez

    Huelva,
    Spain

    Active - Recruiting

  • Hospital Universitario Puerta de Hierro

    Majadahonda,
    Spain

    Active - Recruiting

  • Stanford University

    Stanford, California 94305
    United States

    Active - Recruiting

  • Yale University School of Medicine - Section of Cardiology

    New Haven, Connecticut 06519
    United States

    Active - Recruiting

  • MedStar Washington Hospital Center - MedStar Heart and Vascular Institute

    Washington, District of Columbia 20010
    United States

    Active - Recruiting

  • Mayo Clinic - Jacksonville

    Jacksonville, Florida 32224
    United States

    Active - Recruiting

  • Emory University School of Medicine

    Atlanta, Georgia 30322
    United States

    Active - Recruiting

  • John H. Stroger, Jr. Hospital of Cook County

    Chicago, Illinois 60612
    United States

    Active - Recruiting

  • University of Maryland Medical Center

    Baltimore, Maryland 21201
    United States

    Active - Recruiting

  • Brigham and Women's Hospital

    Boston, Massachusetts 02115
    United States

    Active - Recruiting

  • Mayo Clinic - Rochester

    Rochester, Minnesota 55905
    United States

    Active - Recruiting

  • St. Luke's Hospital of Kansas City

    Kansas City, Missouri 64111
    United States

    Active - Recruiting

  • Rutgers-Robert Wood Johnson Medical School

    New Brunswick, New Jersey 08901
    United States

    Active - Recruiting

  • New York University (NYU) School of Medicine - Langone Medical Center

    New York, New York 10016
    United States

    Active - Recruiting

  • Medical University of South Carolina (MUSC)

    Charleston, South Carolina 29425
    United States

    Active - Recruiting

  • Prisma Health Cancer Institute

    Greenville, South Carolina 89605
    United States

    Active - Recruiting

  • National Neuromuscular Research Institute

    Austin, Texas 78759
    United States

    Active - Recruiting

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